Propafenone Excitation Test And Chest Leads In The Diagnosis Of Brugada Syndrome

Objective To evaluate the effectiveness and specificity of propafenone challenge testing in the diagnosis of Brugada syndrome(BS).Methods Seven consecutive patients who were suspected of BS and 10 normal control cases were included in this study. Physical examination, chest X-ray, and echocardiogram excluded structural heart disease in all patients. The consecutive BS patients also underwent coronary angiography and ventriculography. After defibrillator and cardio-pulmonary resuscitation was available, propafenone challenge test was performed by grades, and standard 12 leads electrocardiogram was monitored continuously and recorded every 5 minutes.Results The result of the propafenone administration is positive in seven consecutive patients, which reach the diagnostic criteria in ESC Consensus Report. Three patients with positive propafenone challenge results and the symptom of syncope were diagnosed as BS, the rest 4 cases was referred to as idiopathic BS ECG pattern. Two BS patients received ICD implantation, one had 14 episodes of nocturnal ventricular fibrillation, the other one had 6 episodes during follow-up of 10 months.The third BS patient who refused ICD implantation died suddenly at night 4 months after the diagnosis for the economical reason. No arrhythmia event occurred in other 5 cases during a follow-up of a mean (10±5) months revealed. There was no other side effect except one patient developed spontaneous ventricular fibrillation 9 minutes after the second intravenous administration of the propafenone. The result of the propafenone administration is negative in control group.Conclusion The data suggested that propafenone challenge testing was effective and specific in the diagnosis of Brugada syndrome.Objective To evaluate the novel precordial leads system for detection of Brugada syndrome.Method 17 consecutive patients who were suspected of Brugada syndrome underwent Physical examination, chest X-ray, echocardiogram, coronary angiography and ventriculography to exclude structural heart disease, then underwent the examination of the novel precordial leads system. The control group included 10 normal cases and 11 patients with atrioventricular node reentry but without syncope and family history for sudden death. The novel precordial leads system constitutes 42 leads (A-G column, 0-5 row), the method for novel precordial leads recording is as same as the standard precordial lead.Results The typical Brugada ST segment elevation was found in 17 consecutive patients by the novel precordial leads system. 8 patients with the symptom of syncope were diagnosed as BS, the rest 9 cases was referred to as idiopathic BS ECG pattern. 5 BS patients who received ICD implantation, 4 ones had nocturnal ventricular fibrillation during follow-up. The other 2 BS patients who refused ICD implantation died suddenly after the diagnosis because of economical reason. No arrhythmia event occurred in other 10 cases during a follow-up of a mean...